Long‐term indoor gunshot exposure of special police forces induces bronchitic reactions and elevated blood lead levels—The Berlin shooting range study

Background Gunshot emissions contain toxic elements that can harm those frequently exposed, such as police officers. Several years ago, police indoor firing ranges were closed by the Berlin municipality in response to police officer health complaints, and an investigation was launched into the possible respiratory health risks of frequent gunshot emission exposure. We, therefore, conducted an exploratory cross-sectional study to investigate clinical and functional parameters of respiratory health as well as the burden of trace elements in policemen with long-term high exposure to indoor gunshot emissions, compared to low-exposure and control groups. Methods We conducted lung function tests and collected blood and urine samples from Berlin police officers and government employees who were divided into three subject groups based on exposure to gunshot emissions: high exposure (n = 53), low exposure (n = 94) and no exposure (n = 76). Lung function was examined using body plethysmography. Blood and urine samples were tested via inductively coupled plasma mass spectrometry for the presence of common gunshot powder elements (antimony, lead and manganese). Exposure and symptoms were assessed using records as well as questionnaires. Results Higher exposure was associated with more respiratory symptoms during gun shooting practice (64% vs. 21%, P < 0.001) compared to the low-exposure group. Headache, cough, discoloured mucous and shortness of breath were also more common as were some other symptoms. The cough symptomatology of the high-exposure group also persisted significantly longer (median: 0.67 vs. 0.01 days, range: 0 to 5 days, P = 0.029) compared to the low-exposure group. They also showed a lower forced expiratory volume in 1 s/forced vital capacity quotient (Tiffeneau index), P = 0.018 between the three groups and P = 0.005 for the high-exposure group, a possible marker of early, subclinical bronchial obstruction. We observed increased blood lead concentrations depending on subject's age (+1.2% per year, 95% confidence interval: 0.5–1.9%, P < 0.001) and cumulative gunshot exposure (+0.34% per 100 000 shots, 0.02–0.66%, P = 0.037). Conclusions These first results suggest that long-term exposure to indoor gunshot emissions induces bronchitic reactions due to repeated irritation of the airways. Higher levels of exposure lead to more negatively impacted lung function and higher blood lead levels with the possible reason that more frequent exposure may mean shorter regeneration phases for the respiratory mucous membrane. We recommend a reduction of exposure to gunshot emissions in order to decrease symptoms and avoid any—even small—deterioration in spirometry

Technische und klinische Validierung einer mobilen Allergenexpositionskammer

Einführung: In der Natur durchgeführte klinische Studien auf dem Feld der Allergologie sind von unabhängigen Faktoren wie der Pollensaison, dem Lebensstil der Probanden oder den klimatischen Bedingungen beeinflusst, was die Vorhersage der individuellen Allergenexposition nahezu unmöglich macht. Allergenexpositionskammern (AEC) wurden entwickelt, um diese Limitationen zu umgehen und jederzeit unter standardisierten Bedingungen mit Allergenen provozieren zu können. Momentan existieren nur wenige Kammern weltweit, was die Durchführung multizentrischer Studien erschwert. Deshalb wurde die Global Allergy and Asthma European Network (GA²LEN) – Kammer entwickelt, eine kosteneffektive mobile Expositionskammer, welche die Durchführung standardisierter Provokationen vielerorts erlaubt. Neben subjektiven Symptombewertungen stellen objektive Parameter Endpunkte in modernen Studien dar. Trotz seiner Praktikabilität wurde der „Peak Nasal Inspiratory Flow“ (PNIF), die maximale Flussgeschwindigkeit bei nasaler Inspiration, bislang kaum für Studien in AEC genutzt. Diese Studie dient sowohl der technischen und klinischen Evaluierung der GA²LENKammer als auch der Etablierung des PNIF als objektivem Parameter für Provokationstests in der Kammer. Methodik: Probanden mit allergischer Rhinitis wurden mit Gräserpollen (Phleum pratense), Birkenpollen (Betula pendula), Hausstaubmilbenmaterial und Placebo provoziert. Sowohl Allergenkonzentration als auch Expositionsdauer wurden variiert, um Unterschiede in der Symptomschwere zu evaluieren. Die Probanden selbst beurteilten vor und alle 10 min während der Provokationen ihre nasalen, okulären und bronchialen Symptome. Zusätzlich wurden alle 30 min während der Tests PNIF, Spitzenfluss bei Exspiration (PEF) und das generelle Wohlempfinden mithilfe einer visuellen Analogskala (VAS) aufgezeichnet. Ergebnisse: An insgesamt 203 Provokationen nahmen 86 allergische Probanden (davon 54,7 % weiblich) teil. Die Testläufe zur klinischen Evaluation bestätigten die Reproduzierbarkeit, die Sensitivität und die Spezifizität. Provokationen mit Hausstaubmilben führten zur größten Reduktion des PNIF, gefolgt von Gräser- und Birkenpollen. Jedes Allergen mit jeder Konzentration führte an mindestens einem Messzeitpunkt zu einem signifikanten Rückgang des PNIF (p < 0,01) im Vergleich zum Ausgangswert. Zudem konnten signifikante Unterschiede (p < 0,05) im PNIF bei Tests mit Gräserpollen und Hausstaubmilben im Vergleich zu Placebo beobachtet werden. Positive Korrelationen zwischen PNIF und PEF sowie Körpergröße und Körpergewicht Seite | 5 und inverse Korrelationen zwischen PNIF und subjektiven nasalen Symptomen sowie der VAS wurden berechnet. Während und 24 Stunden nach den Testläufen wurden keine schweren Nebenwirkungen beobachtet. Schlussfolgerung: Die Mobilität der GA²LEN-Kammer bietet zusammen mit der einfach handhabbaren Bestimmung des PNIF ein sicheres und potentiell effektives Konzept zur Durchführung multizentrischer klinischer Studien im Bereich der Allergologie.Background: Clinical allergy trials conducted in nature are affected by several independent factors such as pollen season, lifestyle or atmospheric variations, thus making it impossible to predict individual allergen exposure of the patients. Allergen exposure chambers (AEC) were developed to overcome these limitations by providing a standardized environment. Currently only a few chambers exist globally complicating the need to perform demanded multicenter trials. The Global Allergy and Asthma European Network (GA²LEN) chamber was built as a cost-effective mobile exposure chamber allowing to conduct standardized expositions at every location. Besides using subjective symptom scores for allergy trials, objective parameters are favored in modern allergy trials. Despite its practicability peak nasal inspiratory flow (PNIF) has been rarely used in the setting of AEC. This study aims to both technically and clinically evaluate the GA²LEN chamber, and assess PNIF as outcome parameter in the chamber. Methods: Subjects suffering from allergic rhinitis were exposed to grass pollen (Phleum pratense), birch pollen (Betula pendula), house dust mite material and placebo. Different allergen concentrations and exposure time intervals were used to evaluate differences in symptom severity. Patients assessed their nasal, ocular and bronchial symptoms subjectively every 10 minutes from start to finish of exposure. Additionally, peak nasal inspiratory flow, peak expiratory flow (PEF) and general well-being using a visual analogue scale (VAS) were recorded every 30 min during the test. Results: 86 allergic subjects (54.7 % female) participated in overall 203 challenges. Clinical evaluation runs confirmed reproducibility, sensitivity and specificity. Provocations with house dust mite caused the greatest reduction in PNIF followed by grass and birch pollen. Every allergen and concentration led at least once to a significant decrease (p < .01) in PNIF compared to baseline. Moreover, in challenges with grass pollen and house dust mite a significant decline in PNIF (p < .05) compared to placebo was observed. Positive correlations were obtained between PNIF and PEF, height and weight, and inverse correlations between PNIF and subjective symptom scoring and the VAS. No severe adverse events were reported during and 24 hours after the test runs. Conclusion: The mobility of the GA²LEN chamber, together with PNIF as helpful and portable tool, provides a safe and potentially effective approach to conduct standardized multicenter provocation trials in the field of allergy

Experiment Results and post-flight Analysis of the ISS Student Experiment PAPELL

Pump Application using Pulsed Electromagnets for Liquid reLocation (PAPELL) was a fast-paced student experiment conducted on the International Space Station (ISS). The 1.5 U flight hardware was integrated internally in an experiment rack of the educational company DreamUp and was executed for over 60 days in total during a half-year stay on the ISS. A multidisciplinary team of more than 30 students of the University of Stuttgart has developed PAPELL within less than a year to flight readiness status. The students have organised themselves within the Small Satellite Student Society of the University of Stuttgart (KSat e.V.) and were supported by the Institute of Space Systems. The technology demonstration experiment aimed to show that a mechanic-free actuation method can be proven by utilising a magnetisable liquid, a ferrofluid, and localised magnetic fields. Such a mechanic-free device is likely to be highly reliable and to have long lifetime. The absence of mechanical moving parts corresponds to minimal wear and tear and generation of vibrations. Lessened qualification requirements reduce development time and overall costs. The PAPELL experiment demonstrated successfully that ferrofluid manipulation by the utilisation of localised magnetic fields generated by electromagnets is possible in a repeatable and reliable way in the microgravity environment of the ISS. The functions of a digital microfluidic circuit, i.e. droplet generation, movement, splitting and merging have been shown during the operation phase. These results allow for a wide variety of application developments based on different transportation modes observed when operating PAPELL. The experiment has been equipped with a sensor suite to ascertain the secondary effects of the experiment. The produced data shows promising results, as disadvantageous effects are minimal. Further, it can be determined that ferrofluid actuation in microgravity requires less power compared to Earth-based tests, while viscosity, surface tension and magnetic field shape effects become significant. Sensor data and analysis of ferrofluid dynamic influenced by magnetic fields in a micro-gravity environment and corresponding behaviour in a ground test environment yields critical information for modelling the corresponding physics and informing future designs. As PAPELL was returned to Earth after mission conclusion, subsequent hardware analysis is conducted for in-depth assessment and respective reproduction experiments are planned